Magnetic resonance imaging for the detection of bone marrow involvement in malignant lymphoma

Abstract

Summary This study systematically reviewed the published data regarding the sensitivity of magnetic resonance imaging (MRI) compared with bone marrow biopsy as reference standard for the detection of bone marrow involvement in patients with malignant lymphoma. A systematic search for relevant studies was performed of the PubMed/MEDLINE and Embase databases. Two reviewers independently assessed the methodological quality of each study and the sensitivity of the included studies was calculated. The 11 included studies had moderate methodological quality. Sensitivity of MRI for the detection of bone marrow involvement ranged from 50% to 100%, with a median of 100%. MRI is probably sufficiently sensitive to rule out bone marrow involvement in patients with malignant lymphoma. However, a well‐designed study with a large sample size is needed to confirm current results.

Clinical utility of 18F FDG-PET/CT in the detection of bone marrow disease in Hodgkin's lymphoma

“…As BMB was the gold standard of staging and treatment in our cohort, the treatment strategy was not altered based on FDG uptake in the bone/bone marrow. MRI is a useful technique for assessing bone marrow [36]; however, so far the role of whole-body MRI is not well-established when compared with whole-body PET/CT. Our study confirms the observation of many authors cited earlier that PET/CT has a high negative predictive value and is a useful tool in the evaluation of the bone/ bone marrow along with BMB.…”

Bone Marrow

“…In patients with lymphoma, MRI has been shown to be superior to scintigraphy in the evaluation of bone marrow. However, it does not appear to be suffi ciently sensitive to exclude marrow involvement [ 29 ]. Furthermore, it cannot differentiate between the different histologic subtypes of lymphoma.…”

“…Marrow infi ltration occurs in 5-15 % of patients with Hodgkin disease and in 25-45 % of patients with non-Hodgkin lymphoma [ 12 , 27 , 29 ]; it indicates stage IV disease, with signifi cant therapeutic and prognostic implications [ 29 ]. On MRI, lymphomatous involvement of marrow is seen as diffuse heterogeneous replacement and less frequently as focal marrow lesions [ 27 ].…”

“…This supplements standard multimodality imaging both for initial tumor staging and to screen for tumor recurrence [ 2 ] and may help detect distant metastatic disease. Pediatric patients may benefi t especially from WB-MRI, as marrow metastases in the peripheral skeleton are more common in children than in adults [ 29 ]. The use of WB-MRI has also been reported in Langerhans cell histiocytosis, chronic osteomyelitis, and systemic muscle diseases [ 30 -33 ].…”

“…The diagnosis of marrow involvement is therefore established with marrow biopsies, which are usually obtained from the bilateral posterior superior iliac crests. Because only a small volume of bone is examined, sampling errors exist [ 29 ]. The diagnostic yield of bone marrow biopsy may be increased if the biopsy site is selected with the aid of MRI [ 12 , 29 ].…”